Rinshō shinkeigaku = Clinical neurology
-
Case Reports
[Unilateral palatal myoclonus with peculiar ocular movements--neurotological studies and MRI].
This is the first report of unilateral palatal myoclonus with which two different ocular movements were synchronized. A 55-year-old woman was admitted to our hospital due to intubation and dysarthria of sudden onset after three similar attacks for these four years. On admission right ptosis, hypalgesia in the right face, right facial nerve palsy, dysarthria, bilaterally increased deep tendon reflexes and trunkal ataxia were noted. ⋯ The direction of nystagmus was converted to the left in stages 1 and 2. Similarly, in a drowsy state induced by intravenous injection of 7 mg diazepam, the direction of the nystagmus was converted to the left. On brain magnetic resonance imaging (MRI) right inferior olive was identified as a well circumscribed, enlarged increased signal area on T2-weighted and proton density-weighted images in addition to the lesions of infarcts in left corona radiata, posterior limb of right internal capsule and tegmentum pontis.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Cerebrospinal fluid (CSF) findings were evaluated in 108 Japanese cases of herpes simplex encephalitis (HSE). The diagnosis was based on clinical, neurodiagnostic and serological examinations. The maximum abnormal values for opening pressure, red blood cell number, total protein concentration, white blood cell number and percentage of polymorphonuclear cell recorded in each case throughout the course of the illness were distributed widely in the range of 80 to 450 mm CSF, 0 to 20,700/cu mm, 15 to 1,390 mg/dl, 0 to 1,089/cu mm and 0 to 85%, respectively. ⋯ Red blood cell was revealed in CSF in 24 out of 61 HSE cases (40%). The number of cases with more than 51 red blood cells/cu mm was 5 out of 10 patients with xanthochromia compared with only 8 out of 50 without xanthochromia. This difference was statistically significant (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
-
Case Reports
[Acute spinal epidural hematoma in MRI-CT, following continuous epidural anesthesia with spontaneous recovery].
We report a case of acute spinal epidural hematoma diagnosed by MRI-CT. A 76-year-old woman was admitted in our hospital for the purpose of the gastrectomy against her early cancer of stomach. Thoracic epidural anesthesia (Th8/9) was attempted for the operation and soft tube was continuously remained in the epidural space after successful gastrectomy. ⋯ Acute spinal epidural hematoma occurred by continuous epidural anesthesia, and with spontaneous recovery is very rare. The hematoma disappeared in MRI-CT on the 26th day after the onset. MRI-CT is useful to detect spinal epidural hematoma safely and accurately for its diagnosis.